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Spending on Health Lobbying Spikes Under Trump

Lobbying spending by health and pharmaceutical groups rose significantly in the first
months of the Trump administration, according to recent filings.

The Pharmaceutical Research and Manufacturers of America, the largest lobbying group
for drugmakers, spent nearly
$8 million on lobbying efforts in the first three months of 2017, nearly double its
average quarterly spend from 2016 and 2015. The American Medical Association also
spent heavily on lobbying, totaling
$6.8 million.

The uptick in spending was likely due to Washington’s health-heavy docket, combined
with the start of a new Congress and new administration, health lobbyists, some of
whom spoke on condition of anonymity, told Bloomberg BNA. It’s unlikely these groups
will continue to spend as much in the next quarter, despite the ongoing debate over
repealing the Affordable Care Act.

Overhauling the ACA has dominated the health agenda on Capitol Hill since Donald Trump
became president, Jennifer Higgins, a partner and health lobbyist at Chamber Hill
Strategies, told Bloomberg BNA. Lawmakers have been so focused on repealing and replacing
the health law that they have had little appetite for other health reforms.

“The AHCA in my opinion is this cloud that hangs over health-care policy as long as
the president and Republicans want to keep it alive,” Higgins said, referring to the
ACA overhaul bill House Republicans are debating.

Republicans in the House have spent much of this year trying to replace the ACA.
Lawmakers tried and failed to bring their ACA bill, the American Health Care Act
(H.R. 1628), to the House floor for a vote in March and have been debating new amendments to the
legislation ever since, hoping the conference can come to agreement.

Reviving the AHCA over and over again with debates over new amendments may keep Congress
from moving on to other health issues, such as authorizing new money for CHIP, the
public health insurance program for children, and tackling rising drug prices, Higgins
said.

Democrats, in some instances working with the Trump administration, have sought to
pass drug pricing legislation. Liberals are also largely concerned with defending
the health law.

ACA Overhaul

House Republicans, at the urging of the White House, continue to try to pass a bill
that would repeal and replace the ACA despite a divide among conservatives over the
legislation.

Trump said April 20 he would like the House to vote on a newly revised version of
the AHCA before hcr716g2May. Rep. Tom MacArthur (R-N.J.) has proposed changes to the
bill he believes can bridge the gap between hard-line conservatives and more moderate
members like himself.

Aides to two members of the conservative House Freedom Caucus told Bloomberg BNA they
are optimistic the conference will come together under MacArthur’s amendment, which
would allow states to waive the ACA’s prohibition on charging people with a history
of illness more for plans than healthier individuals if the state creates a system
for insuring people with the most expensive conditions.

But moderate Republicans in the House have long said they won’t support a bill that
lifts the ACA’s protections for the sick.

Even conservative policy experts are unconvinced.

Michael Cannon, director of health policy studies for the Cato Institute, told Bloomberg
BNA the amendment is “unworkable” because it doesn’t also lift the ACA’s age bands,
which limit how much insurers can charge older people compared to younger people.

Lobbying Figures

Several health and pharmaceutical lobbying groups spent significantly more trying
to influence Congress in early 2017 than they have spent in any three month-period
over the past two years, according to lobbying disclosures due April 20.

Lobbyists for drugmakers listed dozens of bills and laws on their lobbying disclosure
forms, including the ACA’s annual fee on branded drugs and the medical device tax,
the Food and Drug Administration’s user fees and drug importation legislation. Every
pharmaceutical group and drugmaker listed the federal budget on their lobbying forums.

PhRMA, which normally spends between $4 million and $5.8 million per quarter, spent
$7.98 million in the first three months of 2017. The Biotechnology and Innovation
Organization, another drug lobby, spent $2.3 million during the first quarter of 2017,
about the same as the previous quarter and the first quarter of 2016.

Drugmaker Novartis spent $4 million, a $3 million rise over the fourth quarter of
2016 and an $850,000 increase over the first quarter of 2016. Pfizer spent $3.7 million,
$500,000 more than it did in the first quarter of 2016.

Hospital groups, such as the American Hospital Association and the Federation of American
Hospitals, listed the ACA on their lobbying forms. The AMA, which represents doctors,
didn’t specifically name the ACA or the AHCA, but has been a vocal opponent of Republicans’
effort to repeal the health law.

Spending by the AHA dipped slightly in the beginning of 2017, to $4.56 million from
$4.9 million the previous quarter. The FAH, on the other hand, spent more than it
ever has in a single quarter: $1.18 million.

Spending by the largest insurance lobbies, America’s Health Insurance Plans and the
Blue Cross Blue Shield Association, remained relatively flat at the beginning of 2017.
AHIP spent $1.6 million in the first quarter of 2017, up from $1.3 million in the
last quarter of 2016 but down from $2.2 million in the first quarter of 2016.

To contact the reporter on this story: Alex Ruoff in Washington at
aruoff@bna.com

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